LONG SLOG FOR FOREIGN DOCTORS TO PRACTICE IN U.S.

c.2013 New York Times News Service

Thousands of foreign-trained immigrant physicians are living in the United States with lifesaving skills that are lying fallow because they stumbled over one of the many hurdles in the path toward becoming a licensed doctor here.

The onerous tests and often duplicative training these doctors must go through are intended to make sure they meet this country’s high quality standards, which U.S. medical industry groups say are unmatched elsewhere in the world.

But many foreign physicians and their advocates argue that the process is unnecessarily restrictive and time-consuming, particularly since America’s need for doctors will expand sharply in a few short months under President Barack Obama’s health care law. They point out that medical services cost far more in the U.S. than elsewhere in the world, in part because of such restrictions.

The United States already faces a shortage of physicians in many parts of the country. And that shortage is going to get exponentially worse, studies predict, when the health care law insures millions more Americans starting in 2014.

“It doesn’t cost the taxpayers a penny because these doctors come fully trained,” said Nyapati Raghu Rao, the Indian-born chairman of psychiatry at Nassau University Medical Center and a past chairman of the American Medical Association’s international medical graduates governing council. “It is doubtful that the U.S. can respond to the massive shortages without the participation of international medical graduates. But we’re basically ignoring them in this discussion and I don’t know why that is.”

But immigrant doctors, no matter how experienced and well trained, must run a long, costly and confusing gantlet before they can actually practice here.

The counterargument for making it easier for foreign physicians to practice in the United States — aside from concerns about quality controls — is that doing so will draw more physicians from poor countries. These places often have paid for their doctors’ medical training with public funds, on the assumption that those doctors will stay.

“We need to wean ourselves from our extraordinary dependence on importing doctors from the developing world,” said Fitzhugh Mullan, a professor of medicine and health policy at George Washington University in Washington, D.C. “We can’t tell other countries to nail their doctors’ feet to the ground at home. People will want to move and they should be able to. But we have created a huge, wide, open market by undertraining here, and the developing world responds.”